Donovan SCI Pain Classification System

Tool Description

Combines both mechanistic factors (e.g. slow fibre conduction from skin) and descriptive factors, such as time to onset post-injury, characteristics of pain (e.g. burning, stabbing, dull aching, etc), pain duration, and factors that make it worse or better.

ICF Domain:

Body Function – Subcategory: Sensory Function

Number of Items:

5 possible categories for each pain area.

Brief Instructions for Administration & Scoring

Administration:

This information is obtained through a semi-structured, pen and paper interview.

Up to 40 minutes is required for those with complex issues.

Equipment: None

Scoring: N/A

Interpretability

MCID: not applicableSEM: not applicableMDC: not applicable
Presenting the information in a table format (like the one below) facilitates interpretation and clarity. The table below presents the descriptors for 5 different patients with each type of pain (examples for each category shown).

Pain Type

Time of Onset Post Injury

Character

Duration

Aggravating factors

Diminishing factors

Possible causative factors

Segmental nerve

Cauda Equina

Days to weeks

Burning

Stabbing

Seconds

Rest

Activity

Slow fibre conduction from skin

Spinal Cord

Weeks to months

Tingling

Numbness

Constant

Activity

Rest

All fibre conduction within cord

Visceral

Weeks to months

Burning

Constant

Variable

Variable

Slow fibre conduction from viscera

Mechanical

Weeks to months

Dull

Aching

Variable

Activity

Rest

Slow fibre conduction from muscles or ligaments

Psychic

Variable

Variable

Variable

Variable

Variable

Preoccupation with unpleasant environmental stimuli

Languages:

n/a

Training Required:

Knowledge on the study of pain is recommended.

Availability:

See the ‘How-to Use’ page of this tool.

Clinical Considerations

The assessment can be time-consuming for those patients with complex pain issues. However, this type of approach may be more suitable for difficult cases as it allows the patients to explain pain in their own language rather than being forced to pick specific descriptors for their pain.

Measurement Property Summary

# of studies reporting psychometric properties: 2

Reliability:

Overall test-retest reliability is 78%; percentage agreement for segmental nerve/cauda equine was 67%, for visceral was 75%, for mechanical was 80% and for spinal cord was 84%.

Intra-rater agreement ranged from 67-83%.

Inter-rater agreement ranged from 62-73%.

[Richards et al. 2002, Putzke et al. 2003]

Validity:No values were reported for the validity of the Donovan SCI Pain Classification System for the SCI population.

Responsiveness:No values were reported for the responsiveness of the Donovan SCI Pain Classification System for the SCI population.

Floor/ceiling effect:

No values were reported for the presence of floor/ceiling effects in the Donovan SCI Pain Classification System for the SCI population.